Abstract
Integrating family planning programs with local cultures can increase or undermine their effectiveness. Program design and organization will be influenced by kinship and reproductive decision-making, which varies across regions, racial and communal divisions, and religions. Program implementation depends on four aspects of culture: (1) the understanding, acceptance, and continued practice of family planning by clients; (2) the climate in the organizations responsible for fieldwork, which affects the disposition to work and the tasks to be done; (3) the ability and willingness of field implementers to do their work; and (4) the communities in which clients live, including collective attitudes toward family planning and local pressures put on clients to participate. The Indonesian family planning program is a case in which these elements of culture are often positive. Other programs, such as that in Kenya, have a more negative environment for action.
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